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Red States seek to gut the Affordable Care Act and make Blue States more like them.

Red States seek to gut the Affordable Care Act and make Blue States more like them.

In this timely piece from the LA Times we learn about two working mothers, one in California and one in Texas, and their very different health care experiences thanks to the Affordable Care Act’s expansion of Medicaid to low-income adults, or lack thereof, in their states. The California mum (Jenny) whose state enthusiastically embraced the ACA, has health coverage which kicked in last year when she was hospitalized from a severe infection. Texas on the other hand opted out of the Medicaid expansion and the Texan mum’s (Courtney) experience reflects that fact; without health coverage she’s not able to afford asthma inhalers nor dental treatment for a broken molar she received in a domestic dispute. Courtney’s been living on Orajel, she says.

In fact recent research has concluded that the Red States who refused Medicaid expansion suffered a higher mortality rate among near elderly low-income adults compared to states that expanded the program. The result is that the states who opted out likely sustained almost 16,000 avoidable deaths during the period studied. 

The fate of the ACA now rests in the hands of an ideologically extreme right-wing Supreme Court (SCOTUS) in California v Texas stemming from an effort by Texas and 17 other Red States joined now by the Trump administration to overturn the ACA. (The result will not be known until next year). It’s difficult not to see this as anything other than a continuation of an expanding war on Blue States who typically provide their citizens with more and better services. It’s bad enough that Texas and the others demonstrate such a studied unconcern for the health and well-being of their own residents, but it’s truly reprehensible that they’re driven to seriously damage that of low-income people in the rest of America. Apparently, Texas politicians will not rest until Jenny’s experience in California mirrors that of Courtney. Misery really does love company it seems.

And if Republicans win the November election, we can be assured that any chance of a meaningful replacement for the ACA in the event that SCOTUS throws it out will be just as dead as those 16,000 people who died prematurely. Nor should we forget that if the law falls, all who enjoy private health insurance will once again be subject to caps on their coverage, prohibitions on pre-existing conditions and the other means of victimization in the tool bags of the insurance companies. 

All of which is a strong reminder that the sooner we crush the GOP at the ballot box, the better it will be for our collective welfare.

High price paid by states that did not expand Medicaid under Obamacare

High price paid by states that did not expand Medicaid under Obamacare

There has been no shortage of good news about the beneficial effects of the Affordable Care Act, particularly for those states that embraced it; and on the overall reduction in the percentage of uninsured adults in the country.

However, research by the Urban Institute also highlights the steep price paid by states that fought it tooth and nail, notably in the South.

For example, as of June 2014, 49% of the remaining uninsured adults in the United States live in the South, up from 41.5% before the act took effect in September 2013. Furthermore, almost 61% of uninsured adults reside in states that did not expand Medicaid under the ACA compared to less than 50% before the ACA.

And the bad news doesn’t stop there. The Urban Institute has quantified the billions in federal money lost by (mostly Red) states that rejected expanded Medicaid, as explained in this piece from Jonathan Cohn in the New Republic, again based on research by the Urban Institute. The excuse offered by Republican governors that they are simply being fiscally responsible is exposed for the nonsense it is by the map in Cohn’s piece.

Georgia, for example, saves $2.5 billion in what it would have spent to expand Medicaid over the course of a decade, but stands to lose $33.5 billion in federal funds, more than ten times as much. And of course it does nothing for the 20.2 % of Georgia adults who are still uninsured; in fact and as lamented in this piece from The Atlanta Journal-Constitution, the state now has the third highest rate of uninsured behind the perennial champs, Texas and Mississippi.

Talk about cutting off your nose to spite your face!

The economic boom in Texas is no vindication of conservative governance.

The economic boom in Texas is no vindication of conservative governance.

In a recent blog piece in The New York Times, Nobel-prize winning economist and liberal columnist Paul Krugman recounted an effort by Stephen Moore, a conservative economist with the Heritage Foundation, to demonstrate that tax slashing (Red) states have outperformed high tax (Blue) states in job and overall economic growth. It transpired that Moore had evidently been piqued by a column Krugman had written earlier about Kansas GOP Governor Sam Brownback’s disastrous tax-cutting binge which has left the state with a huge deficit while doing next to nothing to grow the economy.

The problem was that the most specific claims in Moore’s article, which appeared in the Kansas City Star, were inaccurate and completely misleading. The Bureau of Labor Statistics data he cited which he said were for the last five years were actually from an earlier period starting just before the last Great Recession. These skewed the numbers to the point of uselessness. Moore claimed he made a “mistake”.  I believe him, but thousands wouldn’t.

Of course we shouldn’t be surprised because ideological blinkering long ago supplanted truth and facts in the alternate universe occupied by most conservatives – even ones with PhDs. And as Krugman says in his piece, comparing states is, in any case, an inexact science given stark differences in key areas such as the price of housing.

But for me it raised a more fundamental question. After all Texas has been extolled as an example of successful conservative governance not only by Moore in his dodgy article, but in a June issue of The Economist a far more credible source. But is it enough to measure success, particularly as it relates to whether a state is well governed, by the number of jobs produced in a given period (one driven, at least in part, by the oil and gas industries) or its economic growth rate? Certainly by these measurements Texas is flourishing; but when viewed against what many consider are other key metrics, such as the economic well-being of its lower-income residents, not so much.

Poverty-USA ranks Texas 40th among states. And in its report on child well-being, the Annie E Casey Foundation  ranks Texas 43rd overall, this in a country which as a whole ranks near the bottom among rich countries. Out of 16 measurements of economic, educational, health, and family/community well-being examined by AECF, Texas only managed to beat the national average in 4 of them. Its efforts in the areas of health and family/community support were particularly dismal.

Finally, this table from the Kaiser Family Foundation shows that the income threshold for adults with children to be eligible for Medicaid is an eye-popping $3,736 for a family of three, placing it only behind Alabama as the stingiest of states. Even Mississippi is more generous (albeit not by much).

And the disparities between states like Texas and their Blue State peers are only likely to grow. This is especially so when it comes to health as the rate of uninsured likely continues to drop significantly in states that fully embraced the Affordable Care Act, while staying the same or decreasing only marginally in Texas and other states that have fought it tooth and nail.

I don’t expect any sense from an ideologue such as Stephen Moore but The Economist should be ashamed of itself for mistaking Texas for a well governed state.

It’s nice to be able to brag about economic growth but what good is it if an ideologically blinkered and uncaring government does little to use the generated wealth to improve the lot of its neediest residents?

Deep Fried Beer at the State Fair of Texas

Deep Fried Beer at the State Fair of Texas

It’s late summer, and you know what that means.  It’s time for y’all to go to a state fair and gorge yourself on all kinds of things that have been submerged in a vat of very hot oil.

Used to be just donuts and other doughy things like fritters and elephant ears, but over the years the stuff they deep fry at fairs has gotten weird:  like Twinkies and Snickers.

Well as the late Dr. Hunter S. Thompson said, “When the going gets weird, the weird turn pro.”

The guy that invented deep-fried beer is a pro.

Story here.

National Education Standards at Last?

National Education Standards at Last?

The good news, potentially, was the release last week of new national standards for math and reading by a panel of experts convened by the National Governors Association and the Council of Chief State School Officers. I say potentially because the standards have to be accepted and adopted by individual states, two of which (Texas and Alaska) have already refused to participate in the process.

The bad news is that to get to this point, it has taken us exactly ten years since the last effort, initiated by President George H Bush (America 2000)  continued under Bill Clinton (Goals 2000) and killed by George W Bush, who replaced it with the disastrous No Child Left Behind.  Where his predecessors’ efforts focused, in part, on encouraging all states to adopt rigorous educational standards while providing federally funded but independent reviews and assessments of the results, Junior’s NCLB has had the opposite effect. Its perverse incentives actually encouraged states to dumb-down their standards, and the tests that stem from them, so as to show illusory improvements in performance. Conversely, states that maintained high standards, such as Massachusetts, have been punished by NCLB.

The pace of reform in this country since ‘A Nation At Risk’ was released during the Reagan years makes a snail look like a sprinter.  It really is enough to make you want to scream in frustration. 

The issue of standards is a case in point. How can anybody actually think that it makes sense to have fifty different sets of standards to determine the appropriate reading level of our ninth-graders, or what our sixth-graders should know in math? Yet the move to national standards has been bitterly resisted, primarily by Republicans in congress who have clung to the manifestly erroneous belief that all educational decisions were best left to individual states and local school districts.  If states were competent to handle it alone, we wouldn’t be lagging most advanced countries in the educational performance of our children 25 years after ‘Nation at Risk’ sounded the warning bell.

It’s heartening that a bipartisan consensus among the nation’s governors has prompted this very significant and long overdue step which could have enormous future benefits for our children. Rigorous national standards will, hopefully, lead to common if not identical curriculum and tests, and a measure of coherence may yet emerge from the patchwork quilt that is the American K-12 education system. 

 That’s definitely worth a loud cheer.